OLYMPIA MEDICAL GROUP, LLC (NPI# 1013473495) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013473495 |
| Entity Type | Organization |
| Organization Name | OLYMPIA MEDICAL GROUP, LLC |
| Practice Address |
2306 North Blvd W Ste C Davenport FL 33837-8976 |
| Practice Telephone | 8635479970 |
| Enumeration Date | 2019-02-11 |
| Last Update Date | 2019-02-12 |
| Authorized Official Name | BALA KODE (MANAGING PARTNER) |
| Authorized Official Telephone | 8635479970 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
2306 NORTH BLVD W STE C |
| City | DAVENPORT |
| State | FL |
| Zip Code | 33837-8976 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174061618 | Mitzy Litzy Mattei Rivera | Nurse Practitioner | 2306 North Blvd W Ste C, Davenport, FL 33837-8976 | 2017-02-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922612274 | Kimberly Zariya Honaker | Massage Therapist | 398 Madison Drive, Davenport, FL 33837 | 2020-09-03 |
| 1609480375 | Sun Health and Wellness, Inc | Pharmacy | 109 Park Place Blvd, Suite A, Davenport, FL 33837 | 2020-09-01 |
| 1093323156 | Tammey Davis Payne | Counselor | 1423 Merrimack Lane, Davenport, FL 33837 | 2020-07-15 |
| 1346872835 | Shelly Hanson | Dietitian, Registered | 40100 Us 27, Davenport, FL 33837 | 2020-02-12 |
| 1689221269 | Adventist Health System /sunbelt, Inc. | Clinic/Center | 40124 Us Hwy 27, Suite 205, Davenport, FL 33837 | 2019-08-20 |
| 1578029039 | Portia P White | In Home Supportive Care | 108 East James St, Davenport, FL 33837 | 2019-02-20 |
| 1366937146 | Sheetal Kirat Parikh | Dietitian, Registered | 40100 Us Highway 27, Davenport, FL 33837 | 2018-06-25 |
| 1063929883 | Marisa Christine Sweetser | Registered Nurse | 40100 Us-27, Davenport, FL 33837 | 2018-01-02 |
| 1104341460 | Haley Kampf | Behavioral Analyst | 4303 Cortland Dr, Davenport, FL 33837 | 2017-08-08 |
| 1013438373 | Tamara Michelle Ortiz | Speech-Language Pathologist | 206 Nova Drive, Davenport, FL 33837 | 2017-06-27 |
| Find all providers in zip 33837 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689287831 | Cynthia Marie Silva | Family Medicine | 142 Harrington Ct, Davenport, FL 33837-8986 | 2020-08-27 |
| 1467013565 | Vibrant Health, P.C. | Family Medicine | 1351 W Central Park Ave Ste 1225, Davenport, IA 52804-1889 | 2019-06-28 |
| 1831667062 | Jacqueline Bogle | Family Medicine | 1334 Oakcrest Ct, Davenport, FL 33837-1707 | 2018-11-06 |
| 1427589944 | Aubrey Riefe | Family Medicine | 4317 E 53rd St, Davenport, IA 52807-3860 | 2017-03-26 |
| 1760748644 | Marygold Lora Fernandez | Family Medicine | 2302 North Blvd W Ste D, Davenport, FL 33837-8920 | 2012-04-05 |
| 1184917981 | Linda Malizia Jager | Family Medicine | 1750 E 53rd St, Davenport, IA 52807-2707 | 2011-05-26 |
| 1881908069 | Andrew Michael Teffeau | Family Medicine | 410 Lionel Way Fl 3, Davenport, FL 33837-7809 | 2010-07-30 |
| 1740509280 | Jose Ascension Armendariz | Family Medicine | 4700 E 56th St Ste 300, Davenport, IA 52807-2904 | 2010-05-24 |
| 1336473198 | Simran Jit | Family Medicine | 3411 Spring St, Davenport, IA 52807-2114 | 2009-09-28 |
| 1184870016 | Maria Nina Concepcion Md Pa | Family Medicine | 2302 North Blvd., Suite D, Davenport, FL 33837 | 2008-08-12 |
| Find all providers in DAVENPORT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.